In this essay, it will be argued that MDMA should be used in psychotherapy and in particular Post-Traumatic Stress Disorder (PTSD) but only in a controlled clinical setting as there is no evidence for MDMA neurotoxicity in such conditions. Mithoefer et al (2011) is a recent study that attempted just that. It reported findings that 83% of participants no longer met DSM-IV criteria for PTSD after MDMA treatment, highlighting its potential value in assisting psychotherapy. A follow up study, Mithoefer et al (2012) found the number of initial participants who were in active psychotherapy had dropped from 84% to 42% after a mean time of 3.5 years since MDMA assisted-psychotherapy.
PTSD is an anxiety disorder where people re-experience symptoms (flashbacks, intrusive thoughts), emotional numbing and hyper-arousal. In neuropsychological terms this can be explained as deficits in extinction learning, alterations in fear conditioning, and sensitization (Pitman et al., 2012). The patient with PTSD constantly monitors the environment for threats, including regarding the therapist with distrust. Having a trusting relationship with the therapist is essential for successful therapy so that the patient feels safe enough to confront their thoughts and feelings. This can be facilitated through clinical administration of MDMA where Johansen and Krebs (2009) concluded that MDMA brought about; acceptance of one's self, induced an increase in openness and communication, an acceptance for others, and enabled traumatic or other negatively salient memories to be processed without fear or avoidance behaviour. The physiological symptoms experienced after ingesting MDMA in a controlled setting are generally mild and tolerable (Mithoefer et al, 2011).
Serotonin (5-HT) is a neurotransmitter considered to regulate mood, appetite, and sleep (Artigas, 2013). MDMA increases the amount of serotonin available in the synaptic clefts. This